Opioid crisis or a serious health care problem?

Opioid crisis or a serious health care problem?

Many of these addictions were the direct result of being prescribed opioids following injuries from a car crash.

All of the media attention lately about the necessity for and proposed location of Safe Injection Sites makes it even more important for us to consider the real impact of reduced first party coverages available to claimants under the current Insurance Act.

At a recent meeting for a school trip my son is taking to Rome next year the convenor stated that the two biggest risk factors to your health while travelling are risk of injury from car accident and illness from failure to wash your hands.

When we read articles about the Opioid Crisis in Ontario it is important to remember that many of these addictions were the direct result of being prescribed opioids following injuries from a car crash. Many of the current addicts are victims of changing policies which have dramatically changed the attitudes of doctors with respect to the appropriateness of prescribing opiate medications leaving addicts with nowhere to turn but to the streets to obtain the medications they depend upon to function.

Unfortunately, that comes without any safeguards in terms of quality of control and unfortunately many of the street drugs are laced with fatal dosages of fentanyl or carfentanyl leading to a crisis in terms of there being an unprecedented number of preventable deaths from fatal drug overdose.

Opioid crisis or a serious health care problem?

The purpose of the supervised injection sites are to save lives by ensuring that naxalone can be administered promptly to counteract the effects of suspected overdose. In my opinion the willingness of communities to consider and demand safe injection sites is a recognition that society must do something to respond to this crisis.

It is more difficult however to reconcile the concerns of communities about having safe injection sites in their communities and to understand the efficacy of saving lives when the same individuals whose lives have been saved are then sent back out into the community to obtain more drugs which may be contaminated for their next fix.

Indeed addicts are having multiple occasions of having their lives saved by naxalone but the underlying problems continue and with the bizarre intersection of the helping professions and criminal drug culture. If addicts help each other and share drugs that end up being laced with fentanyl they can end up facing criminal charges and going to jail. The problem will continue and probably get worse as long as the demand continues.

To stop this problem society must recognize this not as an opioid crisis but as a serious health care problem with addicts being ill people who should not be forced onto the streets because they are addicted to opiates and cannot manage their addictions legally. They should be under the care of doctors who can prescribe them the opioids they depend upon until there are other treatment options for them that will have a reasonable expectation of success.

This problem however underscores how critically important it is for persons injured in motor vehicle collisions to receive a high level of care for their injuries as soon as possible after they are injured in an accident. Unfortunately, under the current regime this is not occurring. Most persons injured in accidents that cause chronic pain are unfortunately initially treated within the framework of the Minor Injury Guideline by their own insurer. This means that their access to treatment modalities such as physiotherapy, massage and chiropractic treatment during the critical period of recovery is capped at $3,500.00.

It is very difficult to fight the Minor Injury Guideline designation as it is based on an overly broad definition of “sprain or strain” which in real terms could range between the very minor to the very serious. If there is a basis to get out of the Minor Injury Guideline the practical reality in terms of timing means that the few months after injury are a period of time where people who need to get the most amount of treatment to maximize their recovery get very little treatment.

It is not too difficult to see how the failure to obtain proper treatment at an early opportunity could jeopardize recovery and lead to the development of a chronic pain syndrome which could lead to a whole host of other problems which could easily include the over reliance on prescription and over the counter medication to manage pain.

It is not too difficult to see how the insurers using the Minor Injury Guideline to offload their responsibilities to their insureds in terms of providing a reasonable amount of treatment to assist them to recover from injuries sustained in accidents can lead to much more serious problems which have implications beyond the individual and for society as a whole.

It is only too easy for us to see the opioid crisis in Ontario as an individual problem related to individual shortcomings and to ignore the role that has been played by insurance companies, doctors and pharmaceutical companies in creating the problems in the first place. Certainly, safe injection sites will save lives, but to solve the problem will require a comprehensive health care focussed approach which will inevitably have to include a way to supervise the supply of opiates to addicts.

Lisa Morell Kelly - Lisa@morellkelly.com

Morell Kelly Professional Corporation